Avaliação de um programa de intervenção de habilidades sociais educativas parentais: um estudo-piloto

Estudos têm apontado relações entre déficits de habilidades sociais educativas de pais e problemas de comportamento de seus filhos. Nesse sentido, esta pesquisa visa a descrever os efeitos de um procedimento de intervenção com pais, o qual pretendeu promover suas habilidades sociais educativas. Participaram dois pais e sete mães, que elegeram o filho com o qual descreveram ter maiores dificuldades de relacionamento. Para a avaliação: 1) das dificuldades dos pais, foi utilizada uma entrevista estruturada, e 2) dos procedimentos de intervenção, foram utilizados: a) questionário de habilidades sociais educativas parentais (QHSE-P) e b) inventário de habilidades sociais (IHS-Del Prette). Os resultados das comparações pré e pós-intervenção do IHS-Del Prette mostraram aumento no escore dos grupos; as comparações do QHSE-P apontaram aquisições de diversas habilidades sociais educativas: expressar sentimentos positivos, agradecer elogios, dizer não e negociar limites. Discute-se a necessidade de procedimentos de promoção de habilidades sociais educativas para ampliar o repertório social parental.

Efeitos do manejo comportamental de incontinência fecal em adolescente

A incontinência fecal, também conhecida como encoprese, é um transtorno de evacuação que acarreta prejuízos ao desenvolvimento psicossocial e orgânico da criança e do adolescente, e que demanda atenção e cuidado de pais e profissionais de saúde. No amplo contexto de tratamento da encoprese, a psicoterapia constitui importante recurso, sendo a terapia comportamental apontada como uma das modalidades mais promissoras e eficazes para o tratamento dessa dificuldade de eliminação. Este artigo apresenta o estudo dos efeitos do manejo comportamental de quadro de incontinência fecal em um adolescente de 14 anos, atendido em clínica-escola de Psicologia do interior do Estado de São Paulo durante 14 meses. A partir do referencial teórico da análise do comportamento, foi desenvolvido, em contexto psicoterápico, um conjunto de estratégias comportamentais com o cliente, bem como orientações aos pais, visando à gradativa extinção encoprética. No decorrer desse processo, o cliente apresentou significativas aquisições comportamentais de uso regular do banheiro e adequado controle esfincteriano, monitoradas semanalmente, que possibilitaram a plena extinção das ocorrências de sujidade, sendo avaliado o efeito em follow-up realizado três meses após o encerramento dessa intervenção.

Intervenção reflexiva: instrumento de formação continuada do educador especial

O presente artigo busca demonstrar a ocorrência de mudanças na prática pedagógica de uma professora, durante o período em que se fez a reflexão teórico-metodológica sobre essa prática, à luz de proposições da Psicologia sócio-histórica. Foram realizados 20 encontros reflexivos com uma professora da Educação Especial, a partir da análise de gravações das situações ocorridas em sala de aula. As discussões promovidas compreendiam aspectos relacionados ao processo de ensino e de aprendizagem na atividade docente. Foram examinadas as locuções verbais da professora e observaram-se indícios de mudança no que se refere ao foco de atenção, quando ela analisa seus problemas pedagógicos, na consideração da multideterminação dos problemas de ensino e aprendizagem, na concepção de aluno, no método de ensino, no estabelecimento e valorização da relação professor-aluno e da interação de alunos. Os resultados obtidos sinalizaram que a interação reflexiva mostrou-se um instrumento útil para a formação continuada de professores.

Avaliação por ressonância magnética funcional e estimulação magnética transcraniana da intervenção única da terapia espelho em pacientes após acidente vascular cerebral isquêmico

Mirror therapy (MT) is being used as a rehabilitation tool in various diseases, including stroke. Although some studies have shown its effectiveness, little is known about neural mechanisms that underlie the rehabilitation process. Therefore, this study aimed at assessing cortical neuromodulation after a single MT intervention in ischemic stroke survivors, by means of by functional Magnetic Resonance Imaging (fMRI) and Transcranial Magnetic Stimulation (TMS). Fifteen patients participated in a single thirty minutes MT session. fMRI data was analyzed bilaterally in the following Regions of Interest (ROI): Supplementary Motor Area (SMA), Premotor cortex (PMC), Primary Motor cortex (M1), Primary Sensory cortex (S1) and Cerebellum. In each ROI, changes in the percentage of occupation and beta values were computed. Group fMRI data showed a significant decreased in the percentage of occupation in PMC and cerebellum, contralateral to the affected hand (p <0.05). Significant increase in beta values was observed in the following contralateral motor areas: SMA, Cerebellum, PMC and M1 (p<0,005). Moreover, a significant decrease was observed in the following ipsilateral motor areas: PMC and M1 (p <0,001). In S1 a bilateral significant decrease (p<0.0005) was observed.TMS consisted of the analysis of Motor Evoked Potential (MEP) of M1 hotspot. A significant increase in the amplitude of the MEP was observed after therapy in the group (p<0,0001) and individually in 4 patients (p <0.05). Altogether, our results imply that single MT intervention is already capable of promoting changes in neurobiological markers toward patterns observed in healthy subjects. Furthermore, the contralateral hemisphere motor areas changes are opposite to the ones in the ipsilateral side, suggesting an increase system homeostasis.

Proposta de Intervenção para Auxiliar a Reabilitação Motora e Cognitiva de Pacientes com Acidente Vascular Cerebral

Stroke is the leading cause of combined motor and cognitive disability worldwide. The rehabilitation of stroke patients is mostly directed towards motor recovery through the training of the affected member under supervision of a Physical Therapist. In the present study we introduce a new approach for both cognitive and motor therapy, which relies on motor imagery of the upper limbs and working memory training. This therapy should be utilized as an adjuvant to physical therapy. Ten individuals (5 men and 5 women) were selected for the pilot study, all of them in the acute phase of the first ischemic stroke episode. The control group had 5 individuals who were submitted to physical therapy only, whilst the other 5 patients in the experimental group also performed the cognitive and motor training with a video game specially built for this study. Two patients left the experimental group before the end. Total training lasted for 9 weeks, 2 times a week, for half an hour. Patients reported they enjoyed playing the game, even though it required a lot of mental effort, according to them. Plus, they considered it had a beneficial influence in their activities of daily living. No side effects were reported. Preliminary results suggest there is a difference between groups in cognitive and upper limb motor evaluation following the intervention. It is important to notice that our conclusions are limited due the small sample number. Overall, this work is supported by other studies in literature focused in rehabilitation with motor imagery and working memory and indicate a continuity of the research, increasing total training hours

Avaliação da relação entre qualidade de sono e uma intervenção com jogos para o desempenho de crianças e adolescentes

The sleep is an active brain process that allows the efficient realization of daily tasks. The changes on sleep patterns may influence the different cognitive processes performance. Many recent studies show the possibility of cognitive performance improvement, through the cognitive training with the use of computer games. The question is if these interventions may be influenced by the sleep quality. Thus, we evaluated the sleep quality effect about the efficacy of an intervention with computers games based on the working memory and attention for a cognitive performance training of elementary school students. The sample was constituted by 42 students with average age of 10,43 years old (SD=1,23), with 22 male participants and 20 female participants. We used to evaluate the sleep with the parents a sleep questionnaire, a sleep diary and the Sleep Behavior Questionnaire. In regard to intervention, the subjectives were distributed in an experimental and in a control group, both with 21 participants. In the first group occurred the intervention that consisted in the working memory and attention training with two cognitive tasks (Safari e Brain Workshop) during 30 daily minutes, for a 6 weeks period. In an equal period, the students from the control group should reproduce an artwork using drawing software. To evaluate the cognitive performance we applied before and after the intervention period the Wechsler Intelligence Scale for Children (WISC-III). The results showed that in both the groups the performance of the intelligence, working memory, attention and visuospatial skills was below of the mean. The cognitive processes evaluated after of intervention in the experimental group had a performance significantly higher in the Perceptual Reasoning Index (t = -6,24; p < 0,01) and in the Full Scale IQ (t = -5,09; p < 0,01) and Performance IQ (t = -6,52; p < 0,01), suggesting a improvement on the visuospatial skills, attention, working memory and processing speed. On the control group, the performance was significantly higher in the Coding subtest (t = -5,38; p< 0,01) and in the Perceptual Reasoning Index (t = -3,66; p = 0,01), suggesting a improvement on the visuospatial skills and attention. The mean obtained with the Sleep Behavior Questionnaire was 53,76 (SD=14,96) for an experimental group and 61,19 (SD=12,82) for a control group, indicating tendency for a bad sleep quality in that last one. Not only during the first days, but also in the last fifteen days of the intervention we verified in the two groups an adequate time to sleep, duration and regularity, in the weekdays and on the weekends. We didn t find significant differences between the two groups in none of the sleep variables. We verified statistically meaningful improvement on the performance of the experimental group with the intervention in the two games. We didn t verify significant correlations between the games performance index and in the sleep variables of the experimental group individuals. We verified significant correlations among the performance on the Brain Workshop and the Cubes subtest, the Perceptual Reasoning Index and the Scale Performance IQ, suggesting that the significant improvement of the visuospatial skills and of the attention was correlated with the performance in the Brain Workshop. Although the absence of correlations with the performance in the Safari, possibly it also has relieved in the improvement of the cognitive performance. The findings support the hypothesis that the computer games might be a satisfactory tool for the improvement of the performance in visuospatial skills and attention. This can be resulted of the insertion of visuospatial stimulations in the task, for example, graphical elements with thematic for children that increase the interest. The IQ below mean the individuals might have influenced the improvement absence on the cognitive processes like the working memory with games. Moreover, it wasn t verified a relation between the sleep quality and the intervention efficacy. It might have been influenced by the n of the sample. Future studies must focalize in the improvement of the effect of the interventions with games

A redução de danos no atendimento especializado em álcool e outras drogas

The harm reduction HR is the official policy of Ministry of Public Health to deal with problem derived from alcohol consumption and other drugs AD. The HR refers to policies and support programs whose purpose is to reduce the risks related to the use of AD, without necessarily decrease individual consumption. This research aim was to analyze the HR conceptions and practices at two specialized institutions for AD users: 1) Psychosocial Care Center Alcohol and Drugs III (CAPSad III); 2) Therapeutic Community Fazenda da Esperança (FE) Dom Bosco. This is a qualitative research that used the following methodological tools: semi-structured interview with 21 professionals; socio demographic file and rounds of conversation with 63 participants users; participant observation and field journal. The interviews with professionals have characterized HR as a less complex and cheap treatment. At FE the HR proposal does not make part of their actions, being considered ―against the human being dignity‖. At CAPSad III is understood as an ―inevitable‖ guideline to service, once users do not remain abstinent. The users understand RD as an improvement in healthy conditions, social relations and work that occurs with the decreasing consumption of AD. They use the HR when they avoid situations that facilitate AD consumption, share relapse prevention strategies and, exclusively at CAPSad III, decrease psychotropic consumption. Stands out as an analyzer the HR comprehension as a less efficient treatment that opposes to the objective of both institutions, which is abstinence. The HR is not operationalize in daily routine by professionals and users as a healthy promotion strategy, however, the users are more affected to HR and produce strategies to face the difficulties arising from the AD consumption

Sofrimento solitário, mal-estar compartilhado :um estudo sobre a doença dos nervos

Nerves has been perceived as generalized suffering with multiple complaints, such as pain and other physical sensations, usually followed by symptoms of anxiety and/or depression. Even after medications have been prescribed, mainly psychotropic drugs to reduce these symptoms, exams aiming to discover the causes of the disorders, and a significant referral to health services, the problem tends to get progressively worse. The objective of this study is to characterize the diseases of clients who complain of nerves at the Unidade Mista de Felipe Camarão, Natal/RN, through in depth interviews, allowing for the clarification of ideas, beliefs and the meanings attributed to nerves by that person; to identify the symptoms and to know how they interfere in daily activities; to investigate the causes attributed to the problem and their relation to the biographical and psychosocial context of the patient. Thirteen women, health service clients, aged 30 to 59 years old, participated in the research. It was observed that they perceive, feel and act in unique ways with relation to symptoms, as well as to the attributed explanations and treatments given, showing the influence of life conditions, family context and their own subjectivity. Daily concerns and overwhelming responsibilities in the domestic environment, which usually stem from their precarious survival conditions, as well as marital conflicts motivated by the inequity of gender relations, contribute to trigger this type of suffering. The methodology of the research itself proved to be crucial to the comprehension and understanding of the meanings attributed to the complaints as well as to the argumenting process and the redefinition of the illness experience. Therefore, the importance of interdisciplinary intervention must be emphasize and specially the role of listening as relevant intervention resource

O dispositivo alta nos Centros de Atenção Psicossocial/CAPS : loucura, vida cotidiana e organização social

The present paper proposes an analysis about the Brazilian Psychiatric Reform as a public policy and deriving from a research developed with the workers of a Psychosocial Attention Centre III (CAPS III) and the managers of the Psychosocial Attention Web (REAP) in Aracaju. This analysis is developed as an investigation of the discharge at those services, understood not as a procedure, but as a dispositive from which different elements can be articulated: users, knowledge, technical procedures, police measures, juridical decisions, laws, services edifying. This, form the background of the articulation between mental alienation and the subject of right alienation, in the ways through which this articulation develops to the relations between madness,citizenship, internment and substitutive practices. Our investigation about the discharge as a dispositive was built with some narrative constructions, as a discourse analysis inspired by Michel Foucault s method, from the perspective of some of the main dispositive operators: workers and managers. The main aspect observed were: the articulations built by the discharge as a dispositive based on two discursive grate, the Reform as a new treatment substituting internship, and the Reform as juridical insertion and users rights practice; the exercise of these discursive grades based on the workers and managers perspective; the transference of limitations and contradictions of these grades to the competence of the dispositive operators, emerged in an outstanding way, as sometimes those operators are liable for the emergent limitations and difficulties, and some other times they are restrained by their institutional role, which is to maintain the domination relations articulated by the dispositive; finally, some aspects extracted which the dispositive operators - when they were expected to act in a way to maintain certain power relations - were capable to resist, managing other power relations from the dispositive, that we call, as Agamben, dispositive profanity

Cartografia de uma intervenção comunitária para prevenção de DST/HIV/AIDS

Community-based interventions have been presented as a proposal of operationalization of the concept of vulnerability to STD/Aids prevention. This study aimed to analyze the Community intervention developed through the project Strengthening of Community action networks for STD/Aids prevention: know and intervenein, at Mãe Luiza neighborhood, in the city of Natal, State of Rio Grande do Norte, Brazil. The study was conducted in the same location where intervention occurs and took as time reference the first 30 months of construction and deployment process, from April 2010 until December 2012. This is research with qualitative approach, participatory character, developed from the immersion of the researcher in the field, being this community intervention itself. In this perspective, the study approximates to the Cartographic method in which the researcher-researched is engendered in the acts and effects research. The data-generating sources were the memories of the researcher from the field notes, written narratives of subjects involved in the intervention and documents pertaining to the project. In the methodological path of cartography, the image of the rhizome by Deleuze and Guattari (1995) has accompanied the immersion in the field given the nature of research-intervention which approach to the concept of object-Rhizome. The presentation of results was composed for the attempted rhizomatic and a hypertext representation, based on the descriptive narrative taken from the documentary analysis and the multi-faceted narratives with the voices, the looks and the affections narrated by the subject involved, respectively. On the path taken, three lanes were drawn as synthesis of learning produced by experience-that can contribute to understanding the process under study, in his singular character, and reflections on other experiences of community intervention: track 1- Community intervention as active-reflective space and a cause; track 2 Inclusion as power and challenge of community involvement; track 3 Sustainability as A challenge of Community intervention. The study indicates that community intervention is presented as a potential producer of health as also produces practical and creative skills, subjects and inventive in the daily life of the community with a view to reinventing knowledge and practices for the prevention of STD/HIV/Aids

Tratamento do Centro de Atenção Psicossocial para usuários de álcool e outras drogas CAPSad II Leste Natal/RN : uma avaliação da efetividade

The treatment for abusive users of alcohol and other drugs suffered significant modifications until arriving to the psychosocial model that is used by Centro de Atenção Psicossocial CAPSad II Eastern Natal/RN (Psychosocial Support Center). That model appears starting from Brazilian sanitary and psychiatric reforms which are expressed in the principles and propositions of Sistema Único de Saúde SUS (Unique System of Health). The Psychiatric Reform meant a rupture with the mental hospital and hospital centered treatment pattern which was destined to the abusive users of alcohol and other drugs. The new proposal offers the universalization, democratization, regionalization and completeness of the actions in the field of mental health. It gathers a strictly interdisciplinary health staff. The purpose of this study is to evaluate the effectiveness of the treatment for abusive users of alcohol and other drugs offered by CAPSad II Eastern Natal/RN. The evaluation used, as priority, the qualitative social research through an evaluating study starting from the non-experimental model. The methodological process used different instruments of data collection: bibliographical and documental researches, systematic observations at CAPSad II Eastern Natal/RN and, mainly, the semistructured interviews (21) that were accomplished with the professionals, users and relatives of CAPSad II Eastern Natal/RN. The investigation showed the effectiveness of the service and, therefore, CAPSad II Eastern Natal/RN constitute itself as the main confronting strategy to the mental hospital and hospital centered treatment pattern of caring the abusive users of alcohol and other drugs

Conflito étnico, direitos humanos e intervenção internacional

Dans cet article, on examine comment les conflits ethniques atteignent de façon négative les droits de l'homme et comment a lieu l'intervention internationale en vue de la défense de ces droits. Pour cela, on oppose la structure qui déclenche des conflits ethniques et un cadre idéal où l'État serait capable d'assurer l'exercice des droits humains, selon l optique soutenue par les Nations Unies. Ainsi, à mesure qu'on dénonce les points où ce genre de conflit mine les fondements de ces droits, on construit un deuxième cadre où ils ne sont pas assurés, et c'est là que se pose la question de l'intervention humanitaire. Enfin, on observe que, malgré l'importance des droits humains dans l'après-Guerre Froide, ils ne forment pas une association d'objectifs. Il faut donc, pour comprendre les critères de sélection qui commandent les interventions humanitaires, prendre en compte d'autres intérêts.

Projeto criança saudável, educação dez: resultados com e sem intervenção do nutricionista

OBJETIVO: Planejar e aplicar um programa de orientação em nutrição, realizado por nutricionista e destinado a professores de 1ª a 4ª série do ensino fundamental, visando analisar a contribuição desse profissional no resultado do projeto Criança Saudável, Educação Dez quanto ao conhecimento dos escolares. MÉTODOS: O trabalho foi realizado em duas escolas públicas, A e B, nas quais foi desenvolvido o projeto educativo, sendo que na primeira os professores foram apoiados por um programa de orientação realizado por profissional nutricionista. Antes e depois do desenvolvimento do projeto educativo foi aplicado um instrumento para avaliar o conhecimento dos escolares sobre alimentação e nutrição. RESULTADOS: Os escolares da Escola A apresentaram mudança significante (p<0,01) no conhecimento de alimentação e nutrição após o desenvolvimento do projeto educativo, o que não ocorreu entre os estudantes da Escola B (p>0,05). CONCLUSÃO: Os resultados obtidos sugerem que a realização de programa de orientação, prestada por nutricionistas aos professores para desenvolverem o projeto educativo, maximizou os resultados, gerando mudança significante no conhecimento dos escolares sobre alimentação e nutrição. Tais resultados apontam a importância da capacitação do nutricionista para atuar em educação nutricional, indicando que o campo pedagógico merece aprofundamento nos cursos de graduação, de modo a permitir ao aluno e futuro profissional uma compreensão alicerçada e sólida do processo educativo.

Avaliação e intervenção da disortografia baseada na semiologia dos erros: revisão da literatura

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Intervenção precoce em escolares de risco para a dislexia: revisão da literatura

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)